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Welcome to the nexus of ethics, psychology, morality, philosophy and health care

Tuesday, May 20, 2014

Dealing with all the behavioral conditions of unknown etiology

By Steven Reidbord
KevinMD.org
Originally published May 1, 2014

Here are some excerpts:

A few years ago I wrote that uncertainty is inevitable in psychiatry. We literally don’t know the pathogenesis of any psychiatric disorder. Historically, when the etiology of abnormal behavior became known, the disease was no longer considered psychiatric. Thus, neurosyphilis and myxedema went to internal medicine; seizures, multiple sclerosis, Parkinson’s, and many other formerly psychiatric conditions went to neurology; brain tumors and hemorrhages went to neurosurgery; and so forth.

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Patients are told they suffer a “chemical imbalance” in the brain, when none has ever been shown. Rapid advances in brain imaging and genetics have yielded an avalanche of findings that may well bring us closer to understanding the causes of mental disorders. But they haven’t done so yet — a sad fact obscured by popular and professional rhetoric. In particular, functional brain imaging (e.g., fMRI) fascinates brain scientists and the public alike. We can now see, in dramatic three-dimensional colorful computer graphics, how different regions of the living brain “light up,” that is, vary in metabolic activity. Population studies reveal systematic differences in patients with specific psychiatric disorders as compared to normals. Don’t such images prove that psychiatric disorders are neurobiological brain diseases?